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<center>
Republic of the Philippines<br />
Province of Albay<br />
MUNICIPALITY OF GUINOBATAN<BR />
OFFICE OF THE MUNICIPAL TREASURER<BR /><BR />
STATEMENT OF THE REAL PROPERTY TAX DELINQUENCY<BR />


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<p>___________________________________<BR />
  ___________________________________<BR />
  ___________________________________</p>
<p>Sir/Madam:</p>
<p>&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;&nbsp; &nbsp; &nbsp; &nbsp;&nbsp;
Records show that you have a real property tax delinquency in the amount of <input name="RefNo" type="text" id="textfield2" value="" size="25" />as of <input name="RefNo" type="text" id="textfield2" value="" size="20" /> hereunder indicated.</p>
<p>&nbsp;</p>
<table width="100%" border="1" cellpadding="1">
  <tr align="center">
    <td width="7%" rowspan="2">TD No.</td>
    <td width="6%">PIN:</td>
    <td width="11%">AREA:</td>
    <td width="8%" rowspan="2">ADDRESS</td>
    <td width="11%" rowspan="2">LOCATION <BR />
    OF<BR />PROPERTY</td>
    <td width="8%" rowspan="2">ASSESSED <BR />
    VALUE</td>
    <td width="12%" rowspan="2">YEARS UNPAID</td>
    <td colspan="2">TAX DUE</td>
    <td colspan="2">PENALTIES</td>
    <td width="12%" rowspan="2">TOTAL <BR />
    AMOUNT<BR /> DUE</td>
  </tr>
  <tr>
    <td>LOT NO.</td>
    <td>DECLARED OWNER</td>
    <td width="6%">BASIC</td>
    <td width="5%">SEF</td>
    <td width="7%">BASIC</td>
    <td width="7%">SEF</td>
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<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
We are constrained to demand payment therefrom you within fifteen(15) days from receipt hereof considering it has been long overdue. In case of discrepancies regarding your tax delinquencies, please do not hesitate to come to this office for adjustment purposes.<br />
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;
Considering further the urgency of this matter, we shall constrained with regrets, to resort to all remedies provided by the law should we fail to get favorable response to the foregoing demand. Thank You.
<br />
<br />
<br />

NOTE: &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This Statement serves as our <input name="RefNo" type="text" id="textfield2" value="" size="20" /> 
demand.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp; Very truly yours,<br />
<br />
<br />

Received by:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input name="RefNo" type="text" id="textfield2" value="" size="58" />&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;  <input name="RefNo" type="text" id="textfield2" value="" size="20" />&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;  MARJORIE O. OCFEMIA
<BR />

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;  &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
Signature Over Printed Name
&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Date

&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;  
Municipal Treasurer

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